Early Pregnancy Assessment Services in Australia: What psychosocial support is available? A qualitative study

ProblemWomen commonly experience emotional distress following miscarriage but do not receive the support they need from healthcare providers.BackgroundMiscarriage can result in psychological morbidity; however, appropriate support at the time of a miscarriage can lead to better psychological outcomes. Early Pregnancy Assessment Services (EPASs) are dedicated outpatient services considered the “gold standard” for miscarriage care. Little is known about the psychosocial support EPASs provide in Australia.AimsThe aim of this study was to explore the provision of psychosocial support in Australian EPASs.MethodsSemi-structured interviews were conducted with 29 purposively sampled key-informants from 13 EPASs. Interviews were audio-recorded, transcribed, and thematically analysed.FindingsConsiderable variation was found in how EPASs functioned and their provision of psychosocial support. Many services were co-located with antenatal services, run by doctors with limited experience and most did not offer any psychosocial training to staff specific to EPAS. Referrals for additional support were generally not offered for first trimester miscarriages, and follow-up typically focused on physical management rather than emotional wellbeing. All EPAS staff demonstrated a strong commitment to providing best possible care to women within their own clinical setting and acknowledged the need for improved psychosocial support.ConclusionThis study provides the first exploration of Australian EPASs’ provision of psychosocial support. It has shown that while health care professionals working in EPASs are dedicated to providing the best possible care to women within their clinical setting, psychosocial support is very limited and could be improved.     

Who killed change management?

A story is told here of an investigation into change management's apparent death, provoked by the dubious business novel Who Killed Change [Blanchard, K., J. Britt, P. Zigarmi, and J. Hoekstra. 2009. Who Killed Change? Solving the Mystery of Leading People Through Change. London: Harper Collins Publishers]. The story is told over eight chapters inviting you to investigate competing explanations for the death of change management using the structure of the story arc: stasis, trigger, quest, surprise, critical choice, climax, reversal and resolution. An annoying voice (sometimes interior monologue and at other times dialogue) of another reader keen to inform and frame your understanding of the status of change management remains ever present. The case is solved with the story's resolution providing insights into advantages of investigating over literature reviewing, the problematic/masculine nature of murder metaphors, the academic potential of story arcs and the mystery which characterises organizational change.     

Improving Risk Management: From Lame Excuses to Principled Practice

The three classic pillars of risk analysis are risk assessment (how big is the risk and how sure can we be?), risk management (what shall we do about it?), and risk communication (what shall we say about it, to whom, when, and how?). We propose two complements as important parts of these three bases: risk attribution (who or what addressable conditions actually caused an accident or loss?) and learning from experience about risk reduction (what works, and how well?). Failures in complex systems usually evoke blame, often with insufficient attention to root causes of failure, including some aspects of the situation, design decisions, or social norms and culture. Focusing on blame, however, can inhibit effective learning, instead eliciting excuses to deflect attention and perceived culpability. Productive understanding of what went wrong, and how to do better, thus requires moving past recrimination and excuses. This article identifies common blame‐shifting “lame excuses” for poor risk management. These generally contribute little to effective improvements and may leave real risks and preventable causes unaddressed. We propose principles from risk and decision sciences and organizational design to improve results. These start with organizational leadership. More specifically, they include: deliberate testing and learning—especially from near‐misses and accident precursors; careful causal analysis of accidents; risk quantification; candid expression of uncertainties about costs and benefits of risk‐reduction options; optimization of tradeoffs between gathering additional information and immediate action; promotion of safety culture; and mindful allocation of people, responsibilities, and resources to reduce risks. We propose that these principles provide sound foundations for improving successful risk management.     

Practical procedures to deal with common support problems in matching estimation

This paper assesses the performance of common estimators adjusting for differences in covariates, such as matching and regression, when faced with the so-called common support problems. It also shows how different procedures suggested in the literature affect the properties of such estimators. Based on an empirical Monte Carlo simulation design, a lack of common support is found to increase the root-mean-squared error of all investigated parametric and semiparametric estimators. Dropping observations that are off support usually improves their performance, although the magnitude of the improvement depends on the particular method used.     

社会资本与身心健康--概念辨析基础上的关系再检验

社会资本与健康研究领域存在核心概念界定不清与理论解释欠缺两大不足。文章在社会网络的视角下对社会资本、社会凝聚和社会支持三个相互杂糅的概念进行辨析区分，并在此基础上以调查数据实证检验了社会资本对身心健康的作用效果与影响机制。结果显示，在控制社会凝聚和社会支持作用的条件下，社会资本依然对自评健康和心理健康存在显著的独立影响，但其对两种健康在影响因素和影响方向上呈现一些差异。其中，网络规模和网络顶端对自评健康和心理健康都具有显著的正向作用，而心理健康同时还受到网络差异的负向影响。从这个角度而言，社会资本对个体身心健康的影响并不必然是积极正向的。     

学习迁移的系统理论:PPEE理论模型的建构和意义

学习是人类社会永恒的主题。为了更好地利用过去的经验，增强学习效果，个人和组织进行学习迁移具有重要意义。学习迁移是指将在以往通过学习或解决问题所获得的经验，用于解决之后所遇到的问题。本文力图建立系统的学习迁移理论，研究人、问题、环境的因素对于学习迁移的影响。本文采用理论推导的研究方法，在前人研究的基础上，提出相应的理论模型。本文运用系统的观点，构建了学习迁移的PPEE理论模型，认为人的因素、问题的因素、人和问题的交互作用、以及环境的调节作用，会共同影响学习迁移的效果。本理论主要从五个方面论述学习迁移的机制。首先，将人的因素按照不同层面划分为后端基本能力、中端心理过程、前端知识结构，讨论了其各自对学习迁移效果的直接影响。其次，将问题的因素划分为形象相似性和抽象相似性，并根据这两个维度构建了四种问题间关系类型，并探究了其与学习迁移效果之间的关系。第三，同时考虑人的因素和问题的因素，研究了二者之间的互动对于学习迁移效果的影响。第四，将环境因素划分为时间紧迫性和空间重要性两个维度，探讨了人和环境，以及问题和环境之间的互动对学习迁移效果的影响。第五，基于系统整体的方面，研究人、问题、环境三者之间的互动对学习迁移效果的交互影响。本文还认为，该模型不仅适用于个人，也同样适用于团队、组织、地区、甚至国家和社会等各个层面，影响各个层面主体的学习迁移。本文最后总结了研究的理论和实践贡献，并提出了未来研究课题。本文对丰富学习理论、特别是学习迁移理论，以及推动教育和管理实践的发展进步具有重要的意义。     

The Common Assessment Framework form 9 years on: a creative process

Legislation within England states that local authorities should provide services for all those families in need. However, research has identified that regardless of the introduction of strategies to identify need and enhance family support, ongoing barriers to services adhere. Taking a social constructionist approach, this study explored professionals' experiences of the use of the Common Assessment Framework form. Data were collected in four different local authorities in two phases. Forty‐one professionals from a variety of agencies took part in semi‐structured interviews. Data were analyzed thematically. Findings demonstrate that the professionals experienced difficulties in working through the Common Assessment Framework process, for example, in completing the form and engaging families. This situation led to the more experienced and knowledgeable professionals utilising creative ways to successfully navigate the ‘referral process’. Such creative working practices included the terminology used to complete the form and how the process was ‘sold’ to parents, so that they could be in a better position to engage parents and complete the Common Assessment Framework form. Because of this, more experienced professionals seem to be able to accelerate the referral process in order to access much needed support services for children and young people.     

The bumpy road to ‘becoming’: capturing the stories that teenage mothers told about their journey into motherhood

Understanding the experience of women who become mothers during their teenage years is central to ensuring that the support that is offered is appropriate to meet their needs. This paper reports on a small part of a larger ethnographic study that captured the lived experience of young mothers who were between the ages of 16 and 19 years that potentially typifies and illuminates the experiences of young women who become mothers in their teenage years. By collecting data from narrative interviews as well as participant and non‐participant observations over an extended period of time it was possible to identify how the young women experienced a range of difficulties as they made their transition into motherhood. Drawing on the findings, this paper argues that this transition for teenage mothers can be significantly different from the experience of older mothers, and it identifies the importance of appropriate support to mediate the challenges that they face. Understanding the young women's journey to ‘becoming’ is critical when planning services because if their experience of support is negative, it can lead to increased levels of maternal stress and reluctance to engage with support services.     

Testing the validity of social capital measures in the study of information and communication technologies

Social capital has been considered a cause and consequence of various uses of new information and communication technologies (ICTs). However, there is a growing divergence between how social capital is commonly measured in the study of ICTs and how it is measured in other fields. This departure raises questions about the validity of some of the most widely cited studies of social capital and ICTs. We compare the Internet Social Capital Scales (ISCS) developed by Williams [2006. On and off the ’net: scales for social capital in an online era. Journal of Computer-Mediated Communication, 11(2), 593–628. doi: 10.1111/j.1083-6101.2006.00029.x] – a series of psychometric scales commonly used to measure ‘social capital’ – to established, structural measures of social capital: name, position, and resource generators. Based on a survey of 880 undergraduate students (the population to which the ISCS has been most frequently administered), we find that, unlike structural measures, the ISCS does not distinguish between the distinct constructs of bonding and bridging social capital. The ISCS does not have convergent validity with structural measures of bonding or bridging social capital; it does not measure the same concept as structural measures. The ISCS conflates social capital with the related constructs of social support and attachment. The ISCS does not measure perceived or actual social capital. These findings raise concerns about the interpretations of existing studies of ‘social capital’ and ICTs that are based on the ISCS. Given the absence of measurement validity, we urge those studying social capital to abandon the ISCS in favor of alternative approaches.     

Spanish migrants to European Union countries: predictors of psychological adjustment / Españoles que emigran a países de la Unión Europea: predictores de su ajuste psicológico

In recent years, the migration of Spanish people to other countries in Europe has increased; however, there are hardly any studies on this phenomenon. The aim of this study is to identify the predictive sociodemographic and psychosocial factors of psychological adjustment (life satisfaction and absence of internalizing symptoms) of emigrants and to determine the indirect effects of these factors through perceived stress. This study also seeks to examine whether the psychological adjustment of Spanish emigrants was similar to Spanish non-emigrants. The sample was made up of a group of Spanish emigrants to Germany and England (n = 858) and an equivalent control group of Spanish non-emigrants (n = 328). The results show that fulfilment of expectations, emotional support and job quality are the best predictors of perceived stress and psychological adjustment. These factors are confirmed to have indirect effects on psychological adjustment through perceived stress. Finally, the mental health of emigrants and non-emigrants was similar, and the implications of these findings are discussed.